Figure 1
Demographic data for cases of CHD and unaffected control patients_
| Characteristic | Case (n = 249) | Control (n = 304) | P |
|---|---|---|---|
| Sex† | 0.033 | ||
| Male | 124 (49.8) | 179 (58.9) | |
| Female | 125 (50.2) | 125 (41.1) | |
| Age† (years) | <0.001 | ||
| <1 | 50 (20.1) | 71 (23.4) | |
| 1–5 | 86 (34.5) | 165 (54.2) | |
| 6–10 | 63 (25.3) | 47 (15.5) | |
| >10 | 50 (20.1) | 21 (6.9) | |
| Gravida | 0.29 | ||
| Primigravida | 112 (45.0) | 123 (40.5) | |
| Multigravida | 137 (55.0) | 181 (59.5) | |
| Parity | 0.67 | ||
| 1 | 118 (47.4) | 140 (46.0) | |
| 2 | 101 (40.6) | 133 (43.8) | |
| 3 or more | 30 (12.0) | 31 (10.2) | |
| History of abortion‡ | 0.050 | ||
| None | 220 (88.4) | 252 (82.9) | |
| 1 | 27 (10.8) | 41 (13.5) | |
| 2 or more | 2 (0.8) | 11 (3.6) | |
| Gestational weeks‡ | 0.02 | ||
| <34 | 0 (0) | 8 (2.6) | |
| 34–36 | 26 (10.4) | 36 (11.8) | |
| ≥ 37 | 223 (89.6) | 260 (85.5) |
Parental risk factors for CHDs on multiple logistic regression_
| Factor | Case (n = 249) | Control (n = 304) | AOR | 95% CI | P |
|---|---|---|---|---|---|
| Family history of congenital heart disease | 0.005* | ||||
| Yes | 21 (8.4) | 6 (2.0) | 4.67 | 1.61–13.57 | |
| No | 228 (91.6) | 298 (98.0) | 1.00 | Ref. | |
| Maternal exposure to second-hand smoke | 0.002* | ||||
| Yes | 151 (60.6) | 121 (39.8) | 1.58 | 1.03–2.42 | |
| No | 98 (39.4) | 183 (60.2) | 1.00 | Ref. | |
| GDM | |||||
| Yes | 11 (4.4) | 31 (10.2) | 0.60 | 0.27–1.33 | 0.21 |
| No | 238 (95.6) | 273 (89.8) | 1.00 | Ref. | |
| Paternal smoking | 0.12 | ||||
| Yes | 134 (53.8) | 124 (40.8) | 1.45 | 0.23–2.88 | |
| No | 115 (46.2) | 180 (59.2) | 1.00 | Ref. | |
| Paternal alcohol drinking | 0.16 | ||||
| Yes | 176 (70.7) | 189 (62.2) | 1.38 | 0.88–2.16 | |
| No | 73 (29.3) | 115 (37.8) | 1.00 | Ref. | |
| History of pesticide exposure | 0.11 | ||||
| Yes | 57 (22.9) | 23 (7.6) | 1.88 | 0.87–4.05 | |
| No | 192 (77.1) | 281 (92.4) | 1.00 | Ref. | |
| Occupation | 0.64 | ||||
| Farmer | 38 (15.3) | 9 (3.0) | 0.68 | 0.14–3.32 | |
| Manual worker | 33 (13.3) | 11 (3.6) | 1.32 | 0.32–5.50 | |
| Merchant/Self-employed | 30 (12.0) | 42 (13.8) | 0.32 | 0.09–1.22 | |
| Employee | 74 (29.7) | 80 (26.3) | 0.43 | 0.18–1.56 | |
| Government officer | 22 (8.8) | 90 (29.7) | 0.16 | 0.04–0.64 | |
| Housekeeper | 43 (17.3) | 67 (22.0) | 0.24 | 0.07–0.89 | |
| Student | 9 (3.6) | 5 (1.6) | 1.00 | Ref. | |
| Maternal educational attainment | 0.50 | ||||
| Primary school or lower | 52 (20.9) | 27 (8.9) | 1.00 | Ref. | |
| Junior high school | 56 (22.5) | 37 (12.2) | 1.58 | 0.71–3.56 | |
| High school | 87 (34.9) | 92 (30.3) | 1.59 | 0.78–3.26 | |
| Bachelor degree or higher | 54 (21.7) | 148 (48.6) | 1.13 | 0.63–2.03 | |
| Family income per month baht (USD)† | 0.53 | ||||
| <10,000 (323) | 55 (22.1) | 44 (14.5) | 1.00 | Ref. | |
| 10,000–30,000 (323–996) USD) | 152 (61.1) | 138 (45.4) | 1.08 | 0.43–2.70 | |
| 30,001–50,000 (996–1610) | 25 (10.0) | 76 (25.0) | 1.40 | 0.65–3.00 | |
| >50,000 baht (>1610) | 17 (6.8) | 46 (15.1) | 0.96 | 0.43–2.12 | |
Parental socioeconomic status univariate analysis_
| Characteristic | Case (n = 249) | Control (n = 304) | OR | 95% CI | P |
|---|---|---|---|---|---|
| Occupation | <0.001* | ||||
| Farmer | 38 (15.3) | 9 (3.0) | 2.35 | 0.63–8.72 | |
| Manual worker | 33 (13.3) | 11 (3.6) | 1.67 | 0.46–6.05 | |
| Merchant/self-employed | 30 (12.0) | 42 (13.8) | 0.40 | 0.12–1.30 | |
| Employee | 74 (29.7) | 80 (26.3) | 0.51 | 0.17–1.60 | |
| Government officer | 22 (8.8) | 90 (29.7) | 0.14 | 0.04–0.45 | |
| Housekeeper | 43 (17.3) | 67 (22.0) | 0.36 | 0.114–1.14 | |
| Student | 9 (3.6) | 5 (1.6) | 1.00 | Ref. | |
| Maternal educational attainment | <0.001* | ||||
| Primary school or lower | 52 (20.9) | 27 (8.9) | 1.00 | Ref. | |
| Junior high school | 56 (22.5) | 37 (12.2) | 0.79 | 0.42–1.47 | |
| High school | 87 (34.9) | 92 (30.3) | 0.49 | 0.28–0.85 | |
| Bachelor degree or higher | 54 (21.7) | 148 (48.6) | 0.19 | 0.11–0.33 | |
| Family income per month baht (USD)† | <0.001* | ||||
| <10,000 (<322) | 55 (22.1) | 44 (14.5) | 1.00 | Ref. | |
| 10,000–30,000 (322–966) | 152 (61.1) | 138 (45.4) | 0.88 | 0.56–1.39 | |
| 30,001–50,000 (966–1611) | 25 (10.0) | 76 (25.0) | 0.26 | 0.14–0.48 | |
| >50,000 (>1611) | 17 (6.8) | 46 (15.1) | 0.30 | 0.15–0.59 | |
Familial biological data as a risk of CHDs on univariate analysis_
| Characteristic | Case (n = 249) | Control (n = 304) | OR | 95% CI | P |
|---|---|---|---|---|---|
| Family history of congenital heart disease | 0.001* | ||||
| Yes | 21 (8.4) | 6 (2.0) | 4.58 | 1.82–11.52 | |
| No | 228 (91.6) | 298 (98.0) | 1.00 | Ref. | |
| Maternal age (years) | 0.67 | ||||
| <20 | 26 (10.4) | 27 (8.9) | 1.00 | Ref. | |
| 20–35 | 183 (73.5) | 221 (72.7) | 0.86 | 0.49–1.53 | |
| ≥ 35 | 40 (16.1) | 56 (18.4) | 0.74 | 0.38–1.46 | |
| Paternal age (years) | 0.84 | ||||
| <20 | 11 (4.4) | 16 (5.3) | 1.00 | Ref. | |
| 20–35 | 164 (65.9) | 194 (63.8) | 1.23 | 0.56–2.72 | |
| ≥ 35 | 74 (29.7) | 94 (30.9) | 1.15 | 0.50–2.62 | |
| Maternal pregnancy complication | |||||
| GDM | 0.013* | ||||
| Yes | 11 (4.4) | 31 (10.2) | 0.41 | 0.20–0.83 | |
| No | 238 (95.6) | 273 (89.8) | 1.00 | Ref. | |
| Pregnancy-induced hypertension | 0.11 | ||||
| Yes | 8 (3.2) | 19 (6.3) | 0.50 | 0.21–1.16 | |
| No | 241 (96.8) | 285 (93.7) | 1.00 | Ref. | |
Parental environmental hazard exposure on univariate analysis_
| Characteristics | Case (n = 249) | Control (n = 304) | OR | 95% CI | P |
|---|---|---|---|---|---|
| Maternal smoking | 0.11 | ||||
| Yes | 6 (2.4) | 2 (0.7) | 3.73 | 0.75–18.64 | |
| No | 243 (97.6) | 302 (99.3) | 1.00 | Ref. | |
| Maternal exposure to second-hand smoke | <0.001* | ||||
| Yes | 151 (60.6) | 121 (39.8) | 2.33 | 1.65–3.28 | |
| No | 98 (39.4) | 183 (60.2) | 1.00 | Ref. | |
| Paternal smoking | 0.002* | ||||
| Yes | 134 (53.8) | 124 (40.8) | 1.69 | 1.21–2.37 | |
| No | 115 (46.2) | 180 (59.2) | 1.00 | Ref. | |
| Maternal alcohol drinking | 0.98 | ||||
| Yes | 16 (6.5) | 20 (6.6) | 0.98 | 0.50–1.93 | |
| No | 232 (93.5) | 284 (93.4) | 1.00 | Ref. | |
| Paternal alcohol drinking | 0.036* | ||||
| Yes | 176 (70.7) | 189 (62.2) | 1.47 | 1.03–2.10 | |
| No | 73 (29.3) | 115 (37.8) | 1.00 | Ref. | |
| History of pesticide exposure | <0.001* | ||||
| Yes | 57 (22.9) | 23 (7.6) | 3.63 | 2.16–6.09 | |
| No | 192 (77.1) | 281 (92.4) | 1.00 | Ref. | |
| History of chemical exposure | 0.53 | ||||
| Yes | 5 (2.0) | 4 (1.3) | 1.54 | 0.41–5.79 | |
| No | 244 (98.0) | 300 (98.7) | 1.00 | Ref. | |
| History of paint exposure | 0.38 | ||||
| Yes | 12 (4.8) | 20 (6.6) | 0.72 | 0.34–1.50 | |
| No | 237 (95.2) | 284 (93.4) | 1.00 | Ref. | |
Diagnosis of congenital heart disease_
| Diagnosis | n = 249 (%) |
|---|---|
| Less severe | 155 (62.2) |
| VSD | 69 (27.7) |
| ASD | 41 (16.5) |
| PDA | 22 (8.8) |
| Pulmonary stenosis | 20 (8.0) |
| Aortic stenosis | 1 (0.4) |
| Aortic regurgitation | 1 (0.4) |
| Coarctation of aorta | 1 (0.4) |
| Severe | 94 (37.8) |
| TOF | 35 (14.0) |
| Double outlet of right ventricle | 13 (5.2) |
| Single ventricle | 11 (4.4) |
| Pulmonary atresia with VSD | 8 (3.2) |
| Ebstein anomaly | 7 (2.8) |
| Transposition of the great vessels | 7 (2.8) |
| Pulmonary atresia with intact ventricular septum | 4 (1.6) |
| Atrioventricular canal defect | 4 (1.6) |
| Tricuspid atresia | 3 (1.2) |
| Anomalous left coronary artery from the pulmonary artery | 1 (0.4) |
| TAPVR | 1 (0.4) |